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November is National Diabetes Month

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November is National Diabetes Month. In 2022, the theme is sharing ways you can work with health care professionals to build a team to help you manage your diabetes. The Center for Disease Control and Prevention lists some of the most common dangers that come with diabetes as:
  • Heart disease and stroke. People with diabetes are twice as likely to have heart disease or a stroke as people without diabetes. Diabetes tends to lower HDL (“good”) cholesterol and raise triglycerides and LDL (“bad”) cholesterol. These changes can increase the risk for heart disease and stroke. Diabetes doubles the risk of heart disease in people for people who smoke.
  • Blindness or loss of visual acuity caused by:
    • Damage to blood vessels in the retina (diabetic retinopathy)
    • Clouding of the lens (cataract)
    • Increased pressure (glaucoma)
  • Kidney disease. High blood sugar levels can damage the kidneys and cause chronic kidney disease (CKD). About one in three adults with diabetes has CKD. If not treated, CKD can lead to kidney failure. A person with kidney failure needs regular dialysis or a kidney transplant to survive. 
  • Nerve damage (neuropathy) that most often affects the feet and legs but can also affect digestion, blood vessels, and heart.Nerve damage causes numbness and pain. 
  • Damage to blood vessels and nerves, especially in the feet, can lead to serious, hard-to-treat infections. Amputation can be the only way to stop the spread of infection.
  • Gum disease. It can lead to tooth loss, making diabetes harder to manage. Gum disease can also increase the risk of type 2 diabetes.
  • Diabetes increases the risk of depression, and that risk grows as more diabetes-related health problems develop.
  • Diabetes diagnosed during pregnancy (gestational diabetes) can cause serious complications for mothers or their babies, such as preeclampsia (high blood pressure caused by pregnancy), injury during birth, and birth defects.
Diabetes complications can be interrelated, and one complication can make others worse. For example, many people with diabetes also have high blood pressure, which in turn worsens eye and kidney diseases. 

2022 – Working with a diabetes management team

The National Institute of Diabetes, Digestive and Kidney Diseases (a division of the US Department of Health and Human Services) sets out some of the main aspects of this year’s program to raise awareness on the best way to manage diabetes.
  • It takes a team to manage diabetes. 
  • Remember that you are the most important participant in your diabetes care. 
  • Work with health care professionals who can offer you the personal care you need may help improve your health. 
  • Ask your primary care provider if you should talk with other health care professionals about your diabetes, like a nutritionist and a certified diabetes educator. 
As well, you should organize your life to make control of diabetes a cornerstone of everything you do:
  • Learn as much as you can about diabetes
  • Create a diabetes care plan and take care to follow the ABCs of diabetes management
  • Take action as soon as you have been diagnosed. This can help to prevent or minimize diabetes-related health problems such as kidney disease, vision loss, heart disease, and stroke
  • Have regular blood pressure and weight checks
  • Put together a diabetes-oriented meal plan. Choose fruits and vegetables, whole grains, lean meats, tofu, beans, seeds, and non-fat or low-fat milk and cheese
  • Make physical activity and healthy eating part of your daily routine, with defined goals. Try to be active most days of the week
  • Consider joining a support group that teaches techniques for managing stress and ask for help if you feel depressed
  • Getting seven to eight hours each night can help improve your mood and energy level.

Revolutions in the field of medication for diabetes

Over the past five years, there have been some dramatic improvements in the range and effectiveness of drugs to control diabetes. While it is important to understand that there are no cures for diabetes, many of the newer medications can effectively control the levels of sugar in the blood, giving patients a way of living longer without many of the consequences that go along with diabetes.
Ozempic delivers semaglutide as a weekly injection.
Before these new drugs, the most common treatments for diabetes were based either on direct insulin administration (injection or oral tablets), or on stimulating insulin production (sulfonylurea class drugs), decreasing glucose production in the liver and lowering intestinal sugar absorption (biguanide class drugs), increasing peripheral insulin sensitivity (thiazolidinediones), and sometimes a combination of two or more or these. More recently, glucagon-like peptide 1 (GLP-1) receptor agonists have overtaken these classes dramatically. GLP-1 agonist​​​​​ works by decreasing glucagon secretion, increasing glucose insulin secretion, and slowing gastric emptying. It is released in response to food, prompting the release of insulin as well as a reduction in appetite.  Two drugs delivering the GLP-1 semaglutide help control blood sugar levels (hyperglycemia) and also reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes.  Ozempic delivers semaglutide as a weekly injection, and Rybelsus in an oral tablet taken once a day.
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